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Updated: May 8, 2026
09:21
Optimized Management of Endovascular Treatment for Acute Ischemic Stroke
Published on: January 18, 2018
European stroke organisation guideline on stroke-associated pneumonia
Andreas Meisel1, Tomasz Dziedzic2, Rainer Dziewas3
1Department of Neurology with Experimental Neurology, Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
European Stroke Journal
|May 7, 2026
Summary
Stroke-associated pneumonia (SAP) guidelines offer recommendations for diagnosis and prevention, emphasizing standardized criteria and early intervention. Preventive antibiotics are not advised, but prompt empirical treatment is crucial for better patient outcomes.
Area of Science:
- Neurology
- Infectious Diseases
- Clinical Practice Guidelines
Background:
- Stroke-associated pneumonia (SAP) is the most common infectious complication post-stroke, significantly increasing morbidity and mortality.
- Limited high-quality evidence necessitates structured recommendations for SAP diagnosis, prediction, prevention, and treatment.
- The European Stroke Organisation (ESO) developed these guidelines using systematic reviews and expert consensus.
Purpose of the Study:
- To provide evidence-based and consensus-driven recommendations for managing stroke-associated pneumonia.
- To address key clinical questions regarding SAP diagnosis, prediction, prevention, and treatment.
- To establish a framework for future research to improve SAP management.
Main Methods:
- An interdisciplinary working group identified 15 relevant clinical questions.
- Systematic literature reviews and meta-analyses were conducted.
- Evidence quality was appraised, leading to evidence-based recommendations and expert consensus statements.
Main Results:
- Standardized diagnostic criteria are recommended for SAP.
- Chest CT and C-reactive protein may aid diagnosis; prediction scores show moderate to good performance.
- Prevention strategies include positioning, early mobilization, and nutritional support; dysphagia screening is vital.
- Preventive antibiotics showed no benefit; prompt empirical antibiotic treatment is recommended for diagnosed SAP.
Conclusions:
- The guidelines provide a structured approach to SAP management, balancing evidence and expert opinion.
- Emphasis is placed on standardized diagnosis, effective prevention strategies, and appropriate antibiotic use.
- Further research is needed to strengthen the evidence base for SAP management.
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